Desoximetasone
Mechanism :
Exact mechanism is unknown. However, steroids generally are known to act by activation of phospholipase A2 inhibitory proteins. They control synthesis of inflammatory mediators like prostaglandins and leukotrienes.
Indication :
- Corticosteroid-responsive dermatoses
Dosing :
Topical forms:
Topical cream in concentrations of 0.05%, 0.25%.
Topical gel in the concentration of 0.05%.
Topical ointment in the concentration of 0.25%.
In the treatment of steroid-responsive dermatoses, desoximetasone is a high-potency topical steroid that must be used only in age >18 years. The drug must be applied sparingly to the affected regions every 12 hours and must be limited to minimum quantity necessary for therapeutic efficacy. Avoid application to the face and discontinue treatment once control is achieved. If there is no improvement in 4 weeks, reassess diagnosis.
Adverse Effect :
Atrophy of skin, stretch marks, acneform lesions, itching, irritation, miliaria, inflammed hair follicles, redness, hypopigmentation, vesicle formation, suppression of HPA axis (if used more than 2 weeks), dryness, dermatitis around the mouth. Telaniectsias, secondary infection.
Cataracts, elevated intra-ocular pressure and glaucoma
Interaction :
Other corticosteroid containing mediaction like betamethasone, hydrocortisone, triamcinalone, other skin care products or cosmetic products.
Lactation :
No known information on the presence of topically administered desoximetasone in milk or whether topical administration of steroids could lead to enough systemic absorption to cause detectable amount in breast milk. Prior to administration, one must consider the risks of neonatal steroid exposure, risk of an untreated condition and benefits of breast-feeding.To reduce possible exposure to an infant through lactation, spray on minimum region of skin for minimum time period while breastfeeding. Ask the lactating female not to spray directly to the nipple and areola to prevent direct neonatal steroid exposure.
Pregnanacy :
No available human data about use of the drug in pregnancy. Hence, there is no known method to evaluate possible drug-associated risk of major birth defects, abortion or adverse maternal/fetal outcome.
Some studies suggest use of high potency topical steroids by the mother may lead to a higher risk of low birthweight neonates. So pregnant women may be advised about its possible risk of low birth weight neonates and to administer the drug on the smallest region of the skin for the minimum time period.
In animal reproduction studies, the drug has been shown to cause fetal malformations and be toxic when given through subcutaneous/dermal route of administration at 3-30 times the recommended human dose based on body surface area.